Bangor committee approves health funding, postpones housing ordinance

[0:01] Michael Beck: we're live good evening it is 8 23 p.m i'm michael beck the chair of the government operations committee with me are committee members counselor miller counselor fish still here coming up actually here as well as myself and council walker of course And also joining us at the table are Public Health Director Jen Gunderman. I have Council Chair Susan Hawes, and I also have Councilors Fleming and the host, Leonard. And our first agenda item is a Referral Resolve authorizing the City Manager to accept an appropriate $426,530 for the Rural Health Transformation Program Nutritional Education program from the University of New England. I believe Director will take this off. [0:56] Unidentified speaker (Public Health Director): Sure, so you may remember previously our department received funding through the University of New England for the SNAP education program. That program was no longer funded by the federal government, and so we had to end that program, which resulted in us laying off two staff members. We were able to keep one staff member under different funding. Well, the Rural Transformation Grant is money that the state is receiving, again, through the federal government, to stand back up nutrition education. It's going to be a little bit different than the SNAP program in that there's going to be less sort of requirements or criteria for people to be able to participate. Previously with SNAP education, our SNAP educators were restricted to which populations they could work with to do nutrition education. This funding will allow nutrition education to start back up again and be able to reach a more broader population. It will allow us to be able to hire a couple of staff to be able to do this work. And so the money is federal funds that are coming to the state, which go to the University of New England, which are subcontracted to us and other entities across the state. [2:19] Carolyn Fish: So is this part of the original SNAP monies that we used to get but it's been cut back substantially, like is this now only like 30 or 37 percent of what we would normally get? [2:33] Unidentified speaker (Public Health Director): No, actually this is a little bit different. Yes, there's two different SNAP. There's SNAP benefits which have been dramatically cut through the state that we don't have anything thing to do with, and then there's snap education program, and the snap education program was completely cut from the federal budget back with a big beautiful bill, and that required then we were ending the program. We laid off staff, and now this money is a different pot of money that the state of Maine has allocated for nutrition education using the infrastructure structure that already existed for SNAP education. Okay, thank [3:12] David Szewczyk: Any other questions? A couple more. [3:18] Wayne Mallar: What percentage of our time is spent with Mobscow versus Muscat? I'm, you know, my feelings. I know your feelings. I mean, I want to take care of Bangor. I'm not really concerned about Muscat or any of the rest of Mobscow County. So what percent other than Bangor? What percent do you get an advantage of in Bangor? [3:38] Unidentified speaker (Public Health Director): All so this funding is linked to the public health districts as you know, and our district includes two counties. I don't have the numbers on what percentage of time or effort that we spent with Bangor. However, Bangor is the most dense population where really most of the work happens, so as this program rolls out we can provide you with more information in terms of where the education is happening. And all of the funding to support this program in terms of staff time and materials is grant funding. It's not any city dollars. [4:13] Wayne Mallar: I understand that. But grant money has to come from somewhere. You know, we're eventually paying for it. But I'm just concerned that the county doesn't assume more responsibility than for the Hobbs County and Cascada County. And I find that Bangor is providing more services than the county. And we don't get the benefit of it all. We get some benefit. They get more benefit by not having to do anything. You get all the grief. [4:43] Susan Deane: Some days. I understand what you're saying, Councilor Mallar. Could we also make the argument that by educating more people on nutrition that they would be less likely to have to be medicated or at a hospital using funds that are coming out of our government. Absolutely. In effect, we're helping more than just Bangor, but we may be lessening the burden in other [5:12] Unidentified speaker (Public Health Director): Areas. Absolutely. And what we have to remember is that there are the residents of Bangor, then there's the people who work in Bangor and travel through Bangor and access some of our critical services like hospital and healthcare. And so you're absolutely right that by increasing nutrition education, we're hoping to reduce chronic disease and other complications. And I think the other part to this is that this infrastructure is built upon the public health districts, the public health districts are trying to use a system that's most efficient as possible to get the funds and the work out without breaking things into small little grants across the whole state where you can't get as much bang for your buck. Oh, gosh, you're gonna quiz me right now. And I should know this. I believe there's is eight districts. And then there's another district that includes all the tribal communities. [6:05] Michael Beck: Our districts number one client. Any other questions? [6:11] Susan Deane: Not a question, but can't we count the branches on the pine tree on our in Maine? I didn't know that. I believe so. I wondered why it changed the shape. And I think that's supposed to be all our districts or maybe it's our counties something we should look into that it's a fun fact that [6:33] Michael Beck: I don't think that's interesting any other questions I believe because this is the 10th first reading so we just need to make the motion ought to pass or not make a recommendation so I'll entertain a motion with a recommendation our full council I want to make a [6:52] Carolyn Fish: A motion that we send this to council for the recommendation to accept and appropriate [7:00] Susan Deane: 426 000 for the world transportation nutrition education program second okay we have a motion [7:07] Michael Beck: With a second any doubt further discussion okay that's the will of the committee before we move on to the next one I just wanted to try to bring to this in the beginning the final item on this agenda the for the Standing Committee on housing given the time we just got the ordinance on Friday I wonder if there be any objection from the committee to postpone that item until a future meeting of the special maybe a special gov ops committee we could do that there any objection to doing that Postponing final conversation number eight We'll move that to a future meeting for time. Make sure we all have a chance to really absorb into the robust conversation. All right, moving on to number two, authorizing the city manager to execute a memorandum of understanding with Wabanaki Public Health and Wellness for a syringe waste program in the amount of $60,300. Public Health Director Jen Gutterman. [8:14] Unidentified speaker (Public Health Director): Thank you. And so this is a MOU to go into the third year of the syringe cleanup program. This was a program that sort of predated my coming on board that was started with Health Equity Alliance in response to the community concerned about significant needle waste in the community. This was a service that people could call around syringe waste on their own personal property,, on business property. People could call the city and it could be directed. After the first year, it was decided that HEAL was no longer the best option to keep this contract. So we initiated conversations with Wabanaki Public Health and Wellness who are interested in doing this work. So a year ago, a little more than a year ago, I brought an MOU to you to work with Wabanaki Public Health and Wellness. We were very fortunate that they were willing to take on this service. So over the past year, we've seen some really great improvements in the program. Wabanaki, based upon the reporting that they do to us, are very efficient and responsive with their responses. They're doing education in the community about proper cleanup. They not only receive phone calls directly to their office, they also receive all the see click fix reports that come to our office right and David Warren brings them over they also collect all the boxes that the city has put up throughout the city and then they also receive a lot of the syringes that the city picks up through public works parks and rec and other locations we have had conversations with the downtown district about how to get their needles [10:02] Speaker G (unidentified): meals and how to work together. [10:04] Unidentified speaker (Public Health Director): The ambassador program, as you know, just works within a certain circumference of the downtown. Wabanaki goes beyond that. One of the other differences is the ambassador program doesn't respond to calls. They'll pick up meals that they see along the way, whereas Wabanaki is responding to calls as well. So that's sort of the background ground around the program. I do want to let you know that they did not spend as much this first year for a couple of different reasons. So as of the end of February, they have filled about $15,394. One of the reasons so the two biggest expenses will sort of the three biggest parts that are expensive for this MOU you is staff time, supplies, and how much it costs for syringe disposal for the company to come, pick it up, and do it all properly. One, they didn't spend as much on supplies because there were a lot of supplies left over from Health Equity Alliance that they used first. They're out of those supplies now. The other piece around staff time, they did not use as much staff time as was first anticipated for the third year of this MOU. We included still a part-time person because dynamics can change very quickly with syringe waste based upon the resources that are out. So if a resource that's collecting needles right now is no longer there, they'll have to step in as well as we're going to be having some ongoing conversations about needle waste in general. Also important to note with this MOU is that they bill actual expenses. So when you're approving the MOU say for sixty thousand dollars, we're not guaranteed where they still bill for their actual time, actual supplies, actual mileage, but I had them build a budget for this year still using that up to a potential of a half-time person covered [Speaker G (unidentified): the other] sorry, the other part to their contract is that they're like most non-profit organizations, there's an indirect rate, and that indirect rate, the amount that they get is directly proportional to what they spend. So when you spend less, you get less indirect. So all those factors meant that this year they just had, they didn't, you know, is only billed out I would say probably after March, you know, less than twenty thousand dollars. So I just want to kind of explain that as we go into assembly questions [12:56] Wayne Mallar: for the director. Well, it doesn't have to do with the sixty thousand, but out of curiosity, do we know, I see the number of meetings we picked up, do we know the number of meetings that have been and dispense in the area, in the needle exchange? [13:13] Unidentified speaker (Public Health Director): So that is available through the Maine CDC. I don't have that number right now, but I could get it to you. And so these numbers just equate to what was picked up. Then there's also the needles that come back to the needle exchange programs as well. So I'm happy to get that data for you. [13:28] Wayne Mallar: I'm just curious if we pick up most of that trash or we don't. [13:32] Unidentified speaker (Public Health Director): So generally speaking, throughout the state, there typically is a difference between the needles dispensed and the needles picked up. And that's for a whole host of different reasons, but we'll be looking at that. There were questions. [13:49] Michael Beck: I had a question. It's about the process itself. When we did last year, we didn't have the opioid settlement committee, and so I guess it made sense at that time that hey, let's just do the MOU, that'll be good. I guess this year, since we had the committee, we just with this whole process, was this something that they applied for, this the thing they didn't get the [14:12] Unidentified speaker (Public Health Director): money for or no this was a service we asked them to do what they applied for was a program that they had wanted to support so they did wabanaki never came to us and said hey this is a project we'd like to do where we fund it was more like oh my gosh heal was doing this we really can't have them do it again who are we going to get to do it and we approached wabanaki to take this on [14:36] Michael Beck: Okay, again, because the other question would be then, you know, with all the other stuff, it's easy to say hey, RFP, you know, it seems to be like the most fair and open transparent kind of thing. That was what the committee did. Is it possible to do an RFP, and if so, who would respond to it? [14:55] Unidentified speaker (Public Health Director): Do we know? I don't know who would respond, but I will say responding to an RFP, you know, is a very timely process. I would be concerned that going to an RFP for this work, for something that we like, I would be concerned that maybe there'd be organ, Wabanaki, I don't know this, but I'd be concerned that maybe they wouldn't apply, because it's like we've been doing this, you asked us to do it. That's where my concern would be, is that an organization that we asked to do it, who did such a great job this year, might not respond. You can absolutely do an RFP. We are gonna go a few months without the service if that's the route you'd like to take. Sure, because my concern just from [15:41] Michael Beck: a transparency, that was the big feedback we got, why we got the committee in the first place. So it's just a question of, you know, why didn't they apply when they had the opportunity to do it, and it sounds like they were told at a time hey, we're gonna ask you back, like what you did. I guess the other question too is just talking about the work that they did, you know, could be the moss database that talked about how we had paid them. I think it was eight thousand six hundred twenty to the end of last year. The $15,394, is that including that last year number? Like it's all the way total? It's a cumulative. Cumulative. Okay. You're just looking at this MOU for the next amount. They didn't spend it all and I haven't done the math on an action cost. It sounds like per needle picked up, it's only that we got a good deal. Dollars, yeah, so that's that's about national average, just I guess just because of the feedback I've gotten from the recovery community, you know, what is something or is there, I guess I want to be able to explain to them why it's the best way to like do this MOU. We're happy with the service, it worked out great, whereas a RFP would be harmful, is what it sounds like, because we have a period of no service and based on the amount of needles they picked up, that three months or whatever would be would be detrimental, that's what I'm hearing. [17:21] Unidentified speaker (Public Health Director): Particularly now that the snow has melted and moving into the summer, we want to have this [17:26] Michael Beck: service in place. Okay, do you, I know that the amount is sixty thousand dollars, do we anticipate we're going to end up needing that full amount or is that just kind of a contingency? [17:41] Unidentified speaker (Public Health Director): You know, and I have to say I specifically ask them to keep the half-time person in, you know, it's all going to depend upon what services are available, if you know what's going to continue to be funded in other ways to help with needle cleanup. If we're working with the current system them they probably won't need, if we're gonna, if it's gonna be a lot like last year, it's so hard to predict, I don't, I don't know, I don't know. Sure, well, what's got me is that three-month [18:17] Michael Beck: period of just no service, you know, and that's that's a risk I don't think that we're taking. Would I guess I would like us to entertain the idea maybe for the next year possibly do the RFP. Yes, yep, and you know getting ahead of it that way, just to just so we can show everybody hey, this is who came through or didn't, and if they don't, then that's absolutely a opportunity then to go back and say, well, no one applied, we like what you did, would you accept the MRU, and I would [18:41] Unidentified speaker (Public Health Director): Even go as too far to say, you know, over this next year, my hope is to bring together the entities that deal with needle waste to talk about what is a good needle waste plan. There's a possibility we may not even want to do this next year, but I think based upon the current circumstances, this is the best avenue to take, and we can take this time to really think about, do we need this? Do we need exactly this? And then if we do, go ahead and RFP it. Okay. [19:08] Michael Beck: Any other questions? So, Councillor Deane. [19:11] Speaker G (unidentified): Just one thing in the wording. [19:13] Susan Deane: Should it, instead of saying an amount of $60,300, should it say an amount of up to? [19:18] Speaker G (unidentified): Yeah, that would probably, it would be reflect. [19:35] Michael Beck: Questions, comments? Do we want to make a motion to accept this as amended so [19:46] Wayne Mallar: move it second there's a motion [19:49] Michael Beck: for a second any other they know or any comments okay looks like that has approval of the council or the committee all right that moves on to number three an HIV activities update once again [20:04] Unidentified speaker (Public Health Director): Director of Public Health Jenna. Sure, I'm, it's late, I'm not going to go into the details, you have the memo here. We are at 41 reported cases as of March 20. A couple of things that I will point out. Tomorrow, Maine CDC Director Dr. Vaugh will be here in Bangor meeting with myself and another staff member to get an HIV update with her and her leadership team. So hopefully, we can get more information on what Maine CDC's strategies, if there's any changing there, is there any resources, you know, what that might look like, so I hope to have some information from that meeting tomorrow. The sort of the bigger, the two bigger pieces to this memo is one around syringe services and one about case management update, so the last time I came to speak with you about a month ago, I told you about the new rules for syringe services, those rules were adopted and they're now sort of live, I guess you would say. One of the things that I would like to propose for your conversation and potential approval is that Bangor Public Health becomes certified as a syringe service provider, not for brick and mortar. We have two brick and mortars, Needlepoint Sanctuary and Wabanaki, already in our community. This would pilot a delivery service. So the new rules adopted opted allow a certified entity to be a delivery. So what this would look like, and what we're suggesting as a pilot, is that we're able to offer delivery to our clients, specifically our case management clients. This could potentially take a little bit of pressure off of the brick and mortars. When you deliver, you're not doing a congregate setting. You're bringing directly to where somebody is. And this would be able to allow us to provide this tool to the clients that we serve. This is a service that's not provided by any other entity. And with Syringe Services, it's more than providing needles. It's also collecting needles. It's doing referrals. It's doing many of the things that we already do. But this would allow us the certification, which at times can open us up to additional funding. it. I'm proposing a pilot between now and the end of the year for this delivery service. [22:37] Carolyn Fish: I'd like to know more detail because now you are a needle sanctuary. Isn't there also now a company with that, you can have the bricks and mortar, but can't you also have some type of mobile service with that. And, you know, I'm just concerned, I'm concerned about the outbreak. But I'm also concerned about the amount of monies in the additional syringe services we've been providing, yet the problem seems to be getting worse and the needle, the needles, you know, that we [23:13] Susan Deane: now have to pick up and are distributed all over the ground [23:16] Carolyn Fish: that's getting worse and I just don't see it's kind of like you know a dog chasing his tail we keep doing more and more and more but the problems instead of at this point I've been expecting to see reports that things are improving but they're getting worse so this doesn't seem to be the answer and would this also be like a you know exactly what would you be doing besides giving out syringes would you be like this would be it would be providing like a safe injection site would your clients be able to inject in front of you and you know I think you guys are busy enough and we have such a big and broad community of economically disadvantaged families and children and elderly that you know I'm not being compassionate you know I'm compassionate about this vulnerable group but you know we spend so much time on our agendas and our ordinances and everything we see for this limited group of people and I understand that this is a huge crisis but I don't know that it's the city of Bangor Alone, you know, we just keep giving and giving and giving and giving, and you know there's a lot of our community that just feels that they're not getting, they're ignored from services that they also need. So I'd like to know exactly how much this would take from your staff. You guys are busy. I think you're all overworked. This would be another added job. We have so many nonprofits and all this opiate money. I'd like to see what our committee would propose with this idea, how they feel about this, how we could maybe hand this off to the experts and let them pick up maybe some of this. So it's not that I love the idea, in a perfect world if we had funds just yes, but you know we're just so limited and we've just put this committee together, but I'd like to see how this might, you know, I'm, I'm willing to hear it, but I'd like more information. Absolutely. [25:17] Unidentified speaker (Public Health Director): And if you bring up some absolutely valid points that are lots of concerns out in the community. This pilot would be simply a delivery service so that, for example, our case managers who are working with their clients can bring them needles when they have a visit. That's basically what it comes down to. You're absolutely right that certified syringe programs that have brick and mortar now can have mobile. They can work within a geographical area. We have no control over that. The only control that we have as a city is that they're based upon our ordinances and based upon our rules and working on being on city property. So this pilot is simply being able to give needles to the clients that we work with. We do not participate in safe consumption site. We don't participate in witnessing active use with our clients. This is just to be able to provide another tool to the clients that we work with. In terms of other SSPs, they are absolutely the two SSPs that we have in our community based upon the new rules are able to do delivery as well. They could be doing delivery, they could be doing mobile, and they don't need to go back and be recertified for that. So that we have a little bit, we actually have not much control over. So we're just looking at a small population of people that we already work with, that we can provide this and we would not be purchasing needles with city dollars, this is state dollars that you get when you're certified as an SSP. [26:56] Susan Deane: Thank you. Is the problem with the needles across [27:02] Speaker G (unidentified): the city getting worse or is it improving? I don't know what that means, like waste. No, I mean it's [27:10] Unidentified speaker (Public Health Director): Like just yeah that needs to be picked up. Yeah well when we look at the number of calls that we've received compared to previous years, there's not a dramatic difference between the last year and this year for ways to pick up. We do hear from the community, like we hear oh my gosh there's syringes here, there's syringes here. Those are not, everything is coming into a report to us to go get [27:36] Angela Walker: picked up. I'm curious the clients that the case managers would be bringing the needles to, have the clients already stated that this is the type of service that they want? So these are [27:55] Unidentified speaker (Public Health Director): people who already, many of them, and this is again only with clients that want, like this isn't about here we've got, this is about having a conversation with a client and saying do you need needles. We have been in situations where clients have been housed and they will not leave their apartment. They will not come out to an SSP. And so in those circumstances, clients have not access to clean needles. And those are really concerning. This would just be for clients who said that they would want that supply from us. There are clients that go to either of the SSPs. You know they do their SSPs according to the protocols and policies they've set for their organizations, and this would just be another tool for us to be able to use [28:49] Angela Walker: I get my wording mixed up a little bit, but because we've talked about so many different things and different meetings and stuff tonight, and I'm kind of wondering the connect, the connection or the unity of Abenaki in their program, this program, and Needlepoint Sanctuary and their meetings and they meeting and talking to each other. I know at one point we did talk about how many needles were being out, so we didn't have that number when we had discussed a little bit earlier. It just seems like adding another program to something that we are already supporting. Definitely we, I'm so sorry my throat was, but definitely something that is important to our city and we care about our community members, but at the same time it's like I do agree with Counselor Fish on some of the issues that you know how many more we do this program and then if that's just only doing this and then we still have these other programs where we're going to come back and do another program for it. I'm not saying I'm not in support of the program of programs that do this. We want people to have access to clean needles. It just seems like another program that I don't know if it's necessary, can [30:32] Unidentified speaker (Public Health Director): I is it okay? So I just want to say Portland Public Health is an SSP, and they as a municipal health department, right, allows them to have a lot of control over how their SSP is run. Throughout the country, it is very common for the local or the county health department to be the SSP. There are definitely non-profit organizations that focus on harm reduction also do that. What I'm proposing is not I like starting up an SSP program. This is about for what we're proposing is this is about piloting an opportunity to be able to bring syringes to clients who aren't going to SSPs so that we can have conversations, you know, how much do you use a day, you know, talking through their use, being able to provide them with access. And that's all that we're looking to pilot right now. So I don't want to give the impression that we want to start up an SSP and do wide distribution. We've been working with Wabanaki over the past year now to watch how an operation happens, because as we know, they really stepped up during when HEAL sort of went away. So we know what we're getting into too a bit from that work. And I don't also want to sort of underscore the piece that it is pretty typical that your municipal health departments are SSPs. And we are not looking to stand up a whole program. We're looking to be able to offer an additional service to the clients that we have. In terms of the SSPs talking to each other, that's a state responsibility. The state certifies the SSPs. They do bring them together on a regular basis. We have asked Maine CDC a number of times to bring the SSPs and us together here in Bangor to do some strategizing. [32:26] Angela Walker: What is the outcome of that? I'm sorry. [32:28] Unidentified speaker (Public Health Director): No,, no, please continue. They have not provided that support. They have not provided it. [32:36] Michael Beck: Go ahead, Council Member. [32:38] Wayne Mallar: So related to this, but you mentioned something that made me think. How many public health departments are there that are involved in the SSP? Is that in Florida? [32:49] Unidentified speaker (Public Health Director): I don't, in the state of Maine. Yes. The only two health departments in the state of maine are us in portland so portland has it so really we don't have anything to compare to because portland is much larger than bank across the country there's other local departments we [33:04] Wayne Mallar: don't care about across the country i'm concerned with maine and bangalore basically thank you [33:12] Susan Deane: I did have a question, but you answered most of them last time. But I'm going back to, I remember when you heard this a while ago, you had talked about keeping it in control of public health rather than outsourcing it to, you said, the experts. But we allowed it to happen with the experts, and they were going to areas we didn't want them in, like here's Park. Remember we had, you know, exchange happening by the library, which was not comfortable for us. So but what you're saying, it's not really going to replace that now. These other services would still take place. This would just be in addition to, and it would not cost anything because your workers already going to the clients, they would just be providing to vendors that are paid for by the state. So no signature whatsoever. And that worker is already going to be on that location. [34:05] Unidentified speaker (Public Health Director): And this would be contingent upon us getting what I'm asking today is just for the okay to go through the application process. We would still have to go through the application process means CDC that takes a month long review. And we may not even be accepted as an SSP based upon just a small little service that we want to provide. [34:23] Susan Deane: And those that might say that you're enabling them by providing needles, they're getting needles anyway. They're using, they're using dirty needles, so their potential could be spreading disease. [34:38] Michael Beck: Oh, I'm just gonna add just a couple questions, but no, you go ahead. I guess the first question is, Wawanaki, are they needs based or they one-to-one exchange? Nobody is needs based. [34:49] Unidentified speaker (Public Health Director): In the state of Maine, there is a limit map. Main access points has been a huge advocate of needs based, needs basis. When you sit with somebody and say, how many needles are you going through in a day? When's the next time that you can be here? Let's do that multiplication. That's as many needles you're gonna get. Wabanaki will give a maximum of 50 needles. The state of Maine was a one-to-one exchange until COVID happened, and now in the rules you can give up to 100 at an exchange. [35:21] Michael Beck: OK, I mean, that seems like a lot. So I guess, to me, need space would fit in there. But Wabanaki is not one-to-one, if that's what I'm trying. [35:31] Unidentified speaker (Public Health Director): Because that's what I was talking about. Well, there's nuances. I would have them comment and talk specifically about their policy. [35:38] Michael Beck: OK, because my concern is that 's who we're learning from. It's my understanding that one-to-one is not the CDC recommended way to do it? [35:48] Unidentified speaker (Public Health Director): So every organization has the CDC, it has the policy. And then there are organizations set their own policies around that. That is based upon supply, how quickly you can get inventory. And it's based upon a particular organization. While we've been working with Wabanaki, we've also been in conversations with MAP. And we've you know we've expanded to understand the different models that are [36:18] Michael Beck: out there sure I just I like to hear needlepoint to the table on this war just because you know looking at this the CDC annual reports about you know they end up with more referrals than Wabanaki do a lot you know that Wabanaki they both do some of the same but there's a lot of things that you viewpoint does do including mobile delivery they do some of that they're not certified to do mobile delivery i thought that was with the change that it became [36:51] Unidentified speaker (Public Health Director): so they've i'm not aware that they have started to do great under the new rules yeah i mean we're [36:57] Michael Beck: checking into them that's what i mean i'm wrong i guess where i need to be educated better i just i guess my other concern is about how the cdc funding works and again the way it was explaining to me and maybe i'm wrong again but it's a set pool and so if you've got three people come pulling from it then in a sense you're kind of pulling away from the other two you know because in other words this is it this is the pool they're given [37:20] Unidentified speaker (Public Health Director): i understand the other thing that's been challenging for me to be honest with you is that the other things that an ssp does around referrals and testing and education we have been doing that for two years, and I've not gotten a single penny from the CDC to do it. We've gotten our infrastructure funds, which were given to us, and then we've used to help with this response, but we have gotten no extra funding to do the work that we've been doing. And because we don't exchange needles, as part of the whole comprehensive package, we haven't been able to access any of that funding. [37:58] Michael Beck: Well, I guess one last point before I hand it over to come from out here but I think we mentioned it before also pieces to is about just knowing how to do this because you know God forbid one of these other providers disappears and the need isn't going to go away so I'm definitely one word more of this proposal you know not close mine to it I just want no more [38:22] Unidentified speaker (Public Health Director): what would you specifically like to know more about so that I can come back [38:26] Michael Beck: prepared I do want to get some clarification Wabanaki about their of change that would be helpful to know because i guess one of my concerns is like all these studies out there talk about need-based being you know not generating additional waste all of that like that's and that's also the best practices is need-based and we don't have a city policy that says we are needs-based we are one-to-one we got one that arguably could be need-based but if nobody is then nobody is but as close as we're going to get to it the needle point And then we got Wacken, Wabanaki, who may be one to one. So we don't, in our city, we don't have a way to really look at the data and say, which policy is best for us. And it would be nice to be able to come together as a city and decide based on the evidence, based on the science, this is the policy and everyone in the city should be following this policy. So I would like to know more about how we can kind of all again on the same page, what's best for these patients, for these people who need these services. So I'd like to hear more about that too. And if we can leverage what we bring to the table as a city and say, we're gonna enter into this, we're learning, we're doing this work, and this is what we know, what we see, and if we can influence that and send it the best way possible, I think that does make a strong case for why we should be SSB, that we could lead the way, show that this is how it should be done. done. So that's where I'm going with it. I would like to see a unified policy because the science is out there. Just everyone following their own piece of it. [40:01] Unidentified speaker (Public Health Director): Just to make sure that's clear, I think we will be challenged to have a citywide policy on how SSPs should be done because there is state law and rule that dictate it. I think there's absolutely a possibility to say, okay, this is what this organization does based upon those state rules and the organization's policies. And this is where we can fit. That's why I think that we have a role to do some delivery. Because we are seeing people, some of our clients, that are not getting to an SSP. And they're concerned about. So I'm more than happy to say, here's what the different SSPs, we'll actually have them come maybe to even talk about it. But in terms of us being able to set a city-wide policy for how ssps are done i don't think that's necessarily the direction that we would want to go in more like okay let's do an inventory of what we have and figure out where the gaps are [40:59] Wayne Mallar: You still all right? Well, the other thing I was going to ask is you must prepare a budget for this. I'd just like to see what the budget is for the 80,000. Oh, maybe I'm looking at the wrong way. We look at the wrong, I've gone through, no problem. There are too many in anywhere, whatever. [41:16] Carolyn Fish: I agree with you that I think we shouldn't get in the weeds of setting policy because there's some first fighting and things change so quickly. But I think that if our vanguard health community did get involved, I think we would like to see how that pilot program we would have should have guidelines around that. And since you explained, you would just be providing needles that are to clients that are already that you're working with, those individuals and not expanding that outside of your client base. That makes sense to me. And I guess, you know, have I had that information, but I still would like to see kind of the outline of the pilot program that you have in mind. So we I have a clear understanding of how you see that one. [42:09] Speaker G (unidentified): Come to flu thank you have a sense of like we're these folks who are newly diagnosed with HIV, like are they members of our unhoused community or are they some of these folks who are kind of homebound and not going out and exchanging needles or do you even know? [42:30] Unidentified speaker (Public Health Director): So the data that we know is the data that means CDC supplies to us and 90 I believe is about 90 of the reported cases of reporting housing instability in the past year and we know in working with this population that sometimes they'll get vouchers and get housed or maybe they'll go into shelter and then they may come out of shelter or may get affected like there's just this fluid movement of in and out of housing it is I would say that I think it's important for us to also remember that there Are people who inject drugs who live in very stable housing I think that there are other high risk transmission factors that are part of this outbreak that aren't being talked about enough by yeah other transmission factors that also need to be taken into consideration so I think that we have just been really focused on this very poor group but I would be in talking with even National experts that there are other people who just haven't been tested yet who may be stably housed so [43:48] Speaker G (unidentified): Since this epidemic began like would you say that the rate at which new cases are diagnosed is like happening more slowly or rapidly, or is it slowing down at all? [44:07] Unidentified speaker (Public Health Director): Yeah, I looked at the data most recently because I tried to compare where we were today, where we were last year, and the year before. And there are definitely moments where there was like a peak of reports, and then it sort of was quiet, and then it peaked back up. What I've noticed over the past couple of months is it's been a trickle. Like it's been one case this month, one case that month, one case this month. So we're not, that could change tomorrow. [Carollynn Lear: Our] Two key strategies that, you know, in talking with national experts, our two key strategies right now are getting as many people who have HIV into viral suppression and getting as many people who are at high risk onto pre-exposure prophylaxis, and as best as we can get them on the long-acting one that lasts six months. So that's our key strategies at that moment, and how can we make that happen? [45:01] Speaker G (unidentified): There are questions. [45:02] Angela Walker: So this is a really weird question I think, but I think any question that I have is a dumb question, so I'm going to ask it. Is case management at Bangor Public Health affordable? It's free, it's [45:14] Unidentified speaker (Public Health Director): Free because it's paid for by opiate settlement funds, and what we have found is one of the keys to our success with that, with case management, is having transportation. We are able to bring clients to where they need to go for appointments, and that when we look at other case management happening even outside of HIV, the ability to transport clients has been a game-changer. [45:39] Angela Walker: My last question, I swear I was getting so long. [45:43] Carolyn Fish: The HIV transmission isn't the needles alone, is it? No. Do we know what the ratio is? [45:51] Unidentified speaker (Public Health Director): I don't have, Maine CDC has not reported it. [45:57] Michael Beck: Any other questions? Okay, I think that wraps up that. Thank you very much for all your attention. [46:02] Unidentified speaker (Public Health Director): So what I, so I'm thinking that the next step is to come back with a more detailed plan for you all to review. Is that what the next step would be? Okay, sure. Well, and ask this [46:12] Michael Beck: Question as well, because we, have not many plans about any kind of standing committee for, you know, opioids or recovery or anything. As the committee, even though it's technically in existence until the 30th of June, is it pretty much done? Have they all gone home and said we're none, there's no way to bring them back to get their opinion as well, is there? Oh, it's possible. [46:39] Unidentified speaker (Public Health Director): Could I offer a suggestion with the, with future opiate settlement? Just a consideration is that you do have a public health department that works with many organizations throughout the city in many different ways. If you would like to go forward on, and we would love to be able to participate maybe in helping to craft that, because we have decades of experience working in substance use disorder right here in our local health department. But and to that point, I mean [47:12] Michael Beck: Maybe giving the opinion or bringing them back that particular career back together, but maybe it would just be helpful to have some opinions from some of those organizations about what your pilot program would be, right, you know, folks you may have talked to about it that can also kind of give us that total picture. Yeah, I'm just looking for as much advice as possible before we make any decision on it. Okay, so that brings us to the next item. Resolve, ratifying staff action to accept and appropriate $80,000 from Maine General to implement outpatient early intervention services with respect to HIV disease. Once again, Public Health Director, Jen Gunderman. [47:55] Unidentified speaker (Public Health Director): Yes, this is something that city manager Lear brought to you when I was unable to join last week. So Maine Health Equity Alliance had federal funds to provide HIV case management to anyone regardless of transmission risk. When they went away, eventually that federal money went back to the federal government. Maine General, who does HIV case management for most of the state applied for those funds and received it, their Horizon Program. They have reached out to us to provide that HIV case management to a broader population. I actually was pretty flattered by that, we were able to set up a case management program robustly, high quality. And so they are looking to provide us with funding for case management services, this is a retroactive amount, and then they're going to also go into a future MOU with us for this upcoming year, and that will come to you in the form of an order, but this was as a resolve to retroactively cover salary for case management services. Now I know that our case management has been funded by opiate settlement funds. And I know there's a question of, well, should that $80,000 come out of opiate settlement funds and back into the pot? And what I'm going to ask is if we can hold off on that conversation, because we need to see what the volume is going to look like with these new clients that we're going to get that are outside of injection drug use, outside of this outbreak, because we may need to hire a third manager to help cover this clientele. So I just am asking if we can just hold off on the sort of taking $80,000 of the opiate settlement funding putting back in the pot until we're able to lay out these plans a little bit more. [50:04] Michael Beck: JOSHUA SHARFSTEIN JR.: Yeah. And the question before I say, just ratifying the acceptance. So that's all we have for today. Comments, questions? Just a follow up about the MOU incoming. Because one of the questions, I guess, came with the original 550 was approved is how are we going to continue to fund it when the money runs out but it sounds like this may be part of that key there's two things so one we've already [50:32] Unidentified speaker (Public Health Director): started the journey of billing so we are our next step is to get an electronical health record that can help us with billing and that's going to go to rfp probably within a month we've worked with franny peabody on what that building looks like we're on a road however in talking with Frannie Peabody, to do case management really well, you have to have another pot of money besides billing, because billing doesn't pay for everything. Billing doesn't look for looking for a client going to an apartment showing with them. It's always important to have a pot of money that you can pull from to pay for staff time, pay for a vehicle that billing will not cover. That's the type of model that we want [51:11] Angela Walker: to work with. no [51:14] Michael Beck: questions no questions i'll obtain a motion on ratifying this i make a motion that we ratified [51:23] Carolyn Fish: staff action to accept this appropriate 80 000 from the general to the outpatient early intervention [51:28] Susan Deane: service with respect to h5 h i think we have a motion with a second any doubt [51:38] Michael Beck: out all right looks like that has the blessing of this committee thank you so much for your time tonight thank you thank you very much okay that brings us to the next item and at this point i'll invite our parks and rec director tracy willett to come and speak to us about the consideration for a wabanaki veterans memorial and broad street park thank you tracy willett [52:02] Unidentified speaker (Parks & Recreation Director): Parks Recreation Director, spring of the last year staff was approached by a representative from Bureau of Veterans Affairs about the possibility of working with a committee to indeed locate a Wapanaki veterans memorial here in Bangor. They're not successful and try and do that in Augusta and they arrived here. So we met with representatives from the group, a couple of whom are here behind me this evening. The possibility of locating here arrived initially at Broad Street Park as an appropriate location for a memorial like this. It certainly aligns with the discussion that was had when the Gomez Monument was removed and certainly an appropriate place for visitors with parking, etc. We recommend at the time that they go to the Cultural Commission, which they have done. We've worked through the last few months confirming indeed the group likes the location, which they do. They also met with the Downtown Partnership, you heard that's referred to their project, and both will be compatible down there in the space. So our ask and recommendation tonight is to allow a monument to be located Broad Street Park so indeed the group can start a fundraising effort for this project and they needed that location confirmation to start that effort. Again, Tim Shea, who I believe is involved in some of the design or will be designing, and Steve Ribble behind me, who's also helping with the group, is here as well if you have any questions of them, but that's our ask of the committee tonight. Questions? [53:45] Susan Deane: Okay, currently what is there, just empty space, just green space currently? [53:52] Unidentified speaker (Parks & Recreation Director): And as I think you saw on the concept that was provided, they would essentially locate this monument in the general vicinity of where the Gomez Monument once was. [54:05] Michael Beck: And just for clarity, so we're not being asked for any tax dollar investment in this? [54:10] Unidentified speaker (Parks & Recreation Director): You are not. You are not. [54:12] Michael Beck: There you go. Any other questions? I believe we're looking for a motion to accept this consideration to actually move forward with this. I'll entertain a motion. Okay, motion second, any doubt? All right, well it looks like it has the blessing of this committee. Thank you. Okay, the next item, I'll invite City Solicitor David Szewczyk to speak to us about an ordinance amending chapter 257 sidewalk section 257 for to require license that's occupied block or obstruct the sidewalk or street. All right, welcome David Tubcheck, city [54:57] David Szewczyk: Solicitor, the city has had experienced some issues with individuals storing materials on sidewalks and esplanades and which obstructs the path of travel for pedestrians and which at times has led to pedestrians stepping out into the street to maneuver around a block portion sidewalk of the esplanade and other times pedestrians have had to attempt to walk over or through a bunch of materials blocking the way. If you look at the body of our ordinance section 257-4 it appears like we already have an ordinance that prohibits this. It says no person shall occupy block obstruct or otherwise use any portion of the city sidewalk esplanade or street for the storage of materials says some other stuff without first obtaining a license from the code enforcement officer covering the period of the occupancy. But the title of that ordinance it has three words in it the title of the ordinance says license required to occupy right-of-way for construction purposes so the title clearly limits it to construction situations and so the proposed change that we are here about is to just eliminate three words for construction purposes. Also the proposed change would include adding a sentence to the subsection e that just says the police department the code enforcement department shall enforce this section. The expectation would be to have the ordinance apply for blocking of sidewalks for any purpose of blocking them with materials and that sort of thing. Chief Hathaway is here to talk about the problems if you would like to, with him. And there are, it's a very small ordinance change and it would be expected to be enforced. It's only a civil type thing there would be no kind of criminal aspect to this but a person who would want to block the sidewalk or street or the esplanade with materials would need to get a license to do so if the proposed three words the froze changes are implemented. Questions [57:26] Susan Deane: currently if someone was to say downtown want to have a sidewalk sale or if a restaurant wanted to take a portion of the sidewalk for outside tables during good weather they would ask for permit and that would be allowed or could oh absolutely yes so this doesn't change anything oh no [57:46] Speaker G (unidentified): thank you i guess i'd like to hear more about like the issues like is it neighborhoods is it businesses where it's been the issue is it a combination of both last summer you might [57:55] David Szewczyk: Remember we had some sidewalks that were blocked, partially blocked with materials, items, trash, debris, specifically Cedar Street, First Street, High Low Street. We couldn't really address it. The challenge with that is sidewalks not blocked in its entirety. So it's not a criminal issue. There were some challenges, folks with mobility issues would have a difficult time passing in a sidewalk with the debris and so forth that was piled on the sidewalk last year. Here we're trying to resolve that by not allowing anything to be on the sidewalk. Sidewalks are for free passage, not for the storage of items. If you want to store something, then you need it, you need to request a permit, and that's, that's what we're asking for. Currently you need to do that if you're going to store construction items on a sidewalk. We're asking for anything to fall under the same expectation. [58:51] Wayne Mallar: Is that also improved cars? [58:54] David Szewczyk: Yes, well you can't park a car on a sidewalk anyway. [59:05] Michael Beck: So I guess I have some concerns just about the broadness of this. For example, does the code describe what a material is? I guess, and this may seem silly to some, but just for example, if I take my niece down in the stroller and I've gone to see the parade, I park my stroller in the sidewalk, you know, and they go to watch the parade, I mean, my stroller's sitting in the parking, you know, in the sidewalk. According to this, I mean, that could be a material, and I could find myself a violation. [59:48] David Szewczyk: You know, the good fortune is you would have common sense police officers that wouldn't do that. [59:51] Michael Beck: Sure, and I, and I, with that, I just, I'm worried about constitutionality. Is there a way for us to tailor it more narrowed, you know, in a way, because we're not describing what materials are, you know, because it could be a, you know, pile of bricks, backpack, protest sign, you know, a coffee cup on a ledge, you know, or again, well, I mean, I think there's other orders for that, but I worry about that, and it just, you know, I just want to see it tailored more narrow to survive that vagueness doctrine challenge as far as again, because there's no standard for, you know. If I have a cart where, who is there a process for me to get a permit for my cart, like is there a standard nice process for how you would get a [1:00:42] David Szewczyk: License to have a cart downtown there. The materials have already been, this has been in effect for decades, and there hasn't been any problem with it as long as it involved construction purposes, right? Sidewalks are, yeah, for walking, right? I don't mean the construction [1:01:01] Michael Beck: purposes. Makes it with like a combined definition, you know. Well, it's bricks, it's going to be the thing we need to build. By taking that out, we're just blowing it wide open now, and I guess we're to do that. Just from a constitutional standpoint, I'm just wondering how we can narrow it. See [1:01:20] David Szewczyk: the constitutional difficulty when you just talk about material blocking a sidewalk? Sure, I walk there. [1:01:28] Michael Beck: Well, yeah, items, I just, because we've had other ordinances come before us where we were concerned about things not being defined, what does that mean, and I would say this falls into the same [1:01:41] David Szewczyk: vain, except that again, this, these provisions are already there. We'd only be removing three words that they've, they've been there for decades, and they haven't had any problems in terms of enforcement or constitutionality. You're removing three words and changing the complete definition [1:01:56] Michael Beck: where it's so narrow before, hey, it's for construction purposes, and now you're saying [1:02:01] David Szewczyk: any material or anything. It's not really narrow for construction purposes. There could be all kinds of materials in the construction context that could block the sidewalk or the streets. Kind of a common sense definition of materials, right? But in this case here, you know, Vegas doctor [1:02:23] Michael Beck: I just, it's worth visiting, I think it's worth visiting, Counselor Runner. I was just going to say [1:02:28] Speaker K (unidentified): that when you say that for the specific ordinance, which was, correct me if I wrong, it was specific for construction, correct? Sure, so that in of itself, there are specific types of materials that are used in construction, and there might be a language that we might not be actually addressing with materials that are related to construction, because actually, to the materials point, what are those materials from a construction standpoint, and do those materials continue to translate to now that we've Expanded outside of construction, are we now going toward like potentially animals that they're like being walked by an individual on a sidewalk, like is someone who's walking like 12 or 13 dogs for example, and they have a huge slew of the sidewalk that they're taking up, is that materials that is now blocking the sidewalk? Like I bring that up as one initial thing, but my point is that I think it is actually not as simple as it sounds to be, because it's specific to construction equipment which does inherently block sidewalks. That is absolutely why the ordinance was in there, because construction equipment does take up a lot of space in terms of this. I think we do actually need to be more specific regarding this, because it could, and I get where you're coming from Chief Hathaway, I too think police officers would be able to use their common sense on what would be appropriately enforced or not, but the point being though is that I think it is on us to make sure that our due diligence is put forward into this amendment, this ordinance, because again materials for construction don't necessarily translate for materials for everything else. [1:04:21] Wayne Mallar: Councilor Miller. Just clarify for me, it says sidewalk, esplanade, off street. So I'm assuming, which is always a bad sign, that the dumpsters that are in the packing spaces on the street all have legal, will as you say notice that they have a license, they have a permit. Okay, that's why I just wanted to be sure. Yes, for sure. That's what I thought. Yes, it's easy to just ask you then later. Okay. [1:05:01] Susan Deane: I just I think this is really a common sense issue. If you're walking, you're walking dogs, if they're a passerby, you are in movement on a sidewalk. When you become stationary and leave anything in your wake, that's a hindrance and that could be a potential hazard. So I don't see the issue with it. Sidewalks are for walking. They're not for sleeping. They're not for sitting. During a parade, that's totally different. But for the most part, you want to keep in motion. If you're downtown, you want to keep people moving through. If you're in a neighborhood, you try to be respectful of your neighbors, you don't put things on your sidewalk and try to walk by, you know, walking around things. But I don't I don't see that this is an issue. I think it just clarifies the fact that if for any reason you need to use a sidewalk you get a permit, if it's not permitted you can't do it. [1:05:58] Carolyn Fish: I agree, I think it's common sense, it's straightforward, you remove three words, and I trust our police department and we as human beings are supposed to use common sense. So I mean, we could think of all kinds of scenarios, if this, if they did this, but I think that what we're trying to do is keep the sidewalks clear. So they're safe, and they give everybody a fair passage for mobility on the sidewalk. So if there was some added language, you know, that maybe said, you know, nothing prominent, but you know, I don't know, to me, it made sense when I read it. I read the ordinance we have and it just lightly clarified it to eliminate the problem we had last summer and probably any sense then a few weeks ago yes it was an obstruction downtown yes right on the sidewalk yeah I'm I'm in favor we can microanalyze everything you do and common [1:06:58] Michael Beck: sense goes always thank you well just to clarify I have done anyone's common sense at this table or any of our police officers I just worry about how it plays out in court should it ever go that route but that's what it says any other questions comments otherwise I'll entertain a motion to move this forward second okay we have a motion with a second I'll be doubting so it'll be a roll call vote councillor meller yes hey cover fish yes comforter walker yes councillor dean yes and I'll be announced on four one or four yeah oh yes one no that moves forward to council and then bring this to what is now our last item of the night a resolve ratifying city applications for fiscal year 27 congressional designated spending for city police airport Public Works and Parks and Recreation and Projects and City Manager Carollynn Lear [1:08:02] Carollynn Lear: will be joining us on that aisle yes so this is where I ask you for forgiveness and I've waited for you to be tired out so that you have no fight left in you no so we had a bit of a aha moment in March early March where one of our department heads actually is the brilliant chief hathaway said hey what about the cds funding this year are we going to do that and that was one of those things where if you didn't have a nine month in city manager she would have been on top of it but I was not familiar with the typical deadlines for those and so we very quickly internally came up with some projects that we believed were ripe for application. I think normally, and I agree it's the preferred process rather than sort of scattershot, is to have a really thoughtful approach to how we apply for that money so that various departments aren't competing with one another. But at the risk of losing out on the opportunity entirely, I said let's go for it and ask for forgiveness. Certainly there's later stages where council can either ask us to withdraw these or not accept and appropriate the money if you don't think there are good use the applications are good uses should we be awarded so it felt like sort of the right way to go we wound up applying for four projects a somewhat small request from the Bangor Police Department was submitted for $165,000 for the purchase of equipment to modernize their evidence response and forensic lab capabilities. The airport, which is always looking for federal funding, was able to quickly identify an ask for $4.2 million to complete the airport wide gate upgrade, bridge gate upgrade project, gates eight and 12 for 4.2 million. Public Works submitted a request for 7.5 million. They have a sort of end of life storage bays for their larger equipment. And actually their storage bays are at end of life, but also don't actually cover all of the equipment it is sort of like half of the equipment is still open to the elements so it actually doesn't serve a great purpose for purposes of protecting the equipment and so we thought that was a good project and I think at 1155 p.m. on the date the application was due Parks and Recreation Director, Tracy Willett. He had actually been contacted by Huston University and Senator King's office, Representative King's office. And they asked him to submit something for the Parks and Rec project. And so he very under the wire got in. He submitted a request for 24 million. In that number is attributable specifically to the third of the project that is the Parks and Rec child care and sort of general facility so if you were looking at the picture all the way to the left and applying for CDS funding for that portion really made sense because as compared to the ice I think the ice is most susceptible to community fundraising opportunities so it didn't make sense to go for that for CDS funding it made sense to go as well as naming rights I think the ice is more attractive for naming rights things like that so it just didn't really make sense to do the ice although from a timing perspective I do think that's actually the more immediate need and so we will be asking for you to retroactively we will do so. The one thing I will note is that when I joined the city, one of the things that was challenging was we had a lot of leadership turnover, not just in the city manager office but in many of the departments. And there was no sort of centralized tracking tool to track and monitor sort of critical statutory obligations. For example, Bill Drew has probably two dozen different reports that he's required to file with the state about property values. Things like this CDS application. I think Councilor Beck, you'll recall, we had conversations during election season about making the bus free on the day of the election. And that was missed because of staff turnover this year and so we are starting to accumulate a really good repository of these tasks so that if you know there's leadership turnover or if someone wins the lottery and doesn't show up for work tomorrow the critical tasks won't get missed like this so hopefully the next city manager decades from now will not make the same mistake. [1:13:40] Michael Beck: Any questions about this item? I'll just make a comment. I appreciate the staff and you getting this in and these are some tremendous opportunities and good luck to us. I hope we hope we get it. We'll get at least. Yeah, there we go. I'll entertain a motion on this item. Second. Yeah, second. Do I have any comments, questions, or doubt? I don't look like it has the community's blessing and so that'll we'll go forward and then just the last item we've already for people who joined the video link we actually moved earlier that we would postpone that to another meeting to give three members time to look forward to the forward session and considering the time that big that's best so I appreciate everyone and we are now adjourned at 9 38 p.m.